Consent Form — Hollywood Waxing Studio

*Please note that waxing does have certain risks and side effects such as skin removal, redness, bruise, scabs, swelling, tenderness, etc.

By signing this form, I am confirming that I have read and understand the above mentioned statement. I understand the procedure and accept the risks. I do not hold the esthetician and/or Hollywood Waxing Studio responsible for any conditions that may occur.

Name

First Name

Last Name

Date of Birth

MM

DD

YYYY

Email

Phone

(###)

###

####

How did you hear about us?

When was the last time you shaved/waxed?

Have you been waxed before?

Yes

No

Have you used any Alpha Hydroxy Acid or Glycolic products?

Yes

No

Are you using Retin-a, Renova, or Accutane?

Yes

No

Are you using any other skin thinning products?

Yes

No

Electronic Signature

First Name

Last Name

STUDIO

CLIENTS

CONNECT